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Gov. Doug Ducey calls on Legislature to pass opioid plan

Arizona Gov. Doug Ducey on Monday called the Legislature into a special session to enact a law he hopes will cut opioid overdose deaths.

The Republican governor's call is a political decision that forces the Legislature to focus in the coming days on what he has called a crisis as deaths of Arizonans from overdoses have increased in recent years. The Legislature's Republican and Democratic leaders support the proposal and could have put it on a fast-track for passage even without a special session.

"We needed urgency and focus on this issue, which is a crisis in our state," Ducey said. "It called for a special session."

Calling a special session means the Legislature could pass the measure in as little as three days with limited time for public comment or analysis of the proposed legislation. The Legislature is in the third week of its yearly session now.

Ducey's proposal bars doctors from prescribing more than an initial five-day supply of pain medication in most cases, boosts pain clinic regulation and adds $10 million to help uninsured people get addiction treatment.

A spokesperson for Crossroads, an Arizona Department of Health Services licensed substance abuse treatment provider, said the additional money being invested into treatment will be used to help men and women with no insurance receive the help they need.

It would also help those who are underinsured, where substance abuse treatment is not covered receive the help they need.

"Almost like gaping a bridge to services," said a spokesperson for Crossroads.

The proposal also places limits on the maximum dose most chronic pain patients can be prescribed and requires that an opioid antidote drug called naloxone be prescribed when people are on high doses of narcotics.

The limit on maximum doses is designed to prevent overdoses, and the limit on so-called "first fills" is designed to prevent people from becoming addicted to pain medication.

"This epidemic is unique, because it too often starts inside a doctor's office or behind a pharmacy window," Ducey said. "This is preventable, and today is a big next step, but not our last step. This crisis didn't start overnight and it will not end overnight."

The Republican governor said he wants to protect people with chronic pain while trying to cut the number of new addictions. He declared an opioid emergency in June and the state Health Services Department put in place real-time overdose reporting rules. Between June 15 and Dec. 28, 2017, the department tracked more than 4,900 suspected overdoses and 716 suspected deaths.

"There will be no change for patients that have severe pain," he said. "This is to avoid addiction going forward. We're going to get the education to the doctors that they need, we're going to get the naloxone to the first responders that's important."

Barby Ingle, the president of the iPain Foundation represented the 2.4 million chronic pain patients in Arizona. She's worried the new laws if acted upon too quickly with little to no public input, could lead to more suffering and death among chronic pain patients. Ingle was a chronic pain patient herself.

"When you're a chronic pain patient you are not looking for that high that prescription drugs can give someone. We are not crushing it up, snorting it. We are not doing all of the illicit things you'd expect with an addict," said Ingle.

According to the National Conference of State Legislatures, states began passing law to limit "first fills" in 2016, with Massachusetts passing a law setting a seven-day limit. Six other states joined in similar limits that year, and 24 states had adopted some limit, guidance or requirement on prescribing by last August.

Other details contained in Ducey's plan include a requirement that doctors use electronic prescriptions to cut down on forgeries, criminal penalties for manufacturers who fraudulently market their products and a ban on doctors, dentists, physician assistants and other prescribers dispensing the drugs in their offices.

The law would also require all doctors who prescribe narcotics to take three hours of continuing training on opioids every other year. That would be included in their required 40 hours of training.

The bill also includes a "good Samaritan" provision that bars prosecution of someone who seeks help for an overdose victim if they're discovered with drugs as a result. Similarly, an overdose victim can't be prosecuted for drug possession when they call for help.

The actual legislation wasn't expected to be released until late Monday, with committee hearings, debate and votes expected in the coming days. It could be on Ducey's desk by Thursday afternoon if no major hitches develop.

Democratic Rep. Rebecca Rios, the House minority leader, acknowledged that pushing the proposal though in a special session could lead to unexpected results because the bill won't be in the public light for long before votes are required.

"The beauty of this is if there are unintended consequences we can always come back later," she said. "But hopefully we won't be doing that."

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